Efficacy of at home monitoring of foot temperature for risk reduction of diabetes-related foot ulcer: A meta-analysis

Jonathan Golledge, Malindu E Fernando, Chanika Alahakoon, Peter A Lazzarini, Wouter B Aan de Stegge, Jaap J van Netten, Sicco A Bus

Research output: Contribution to journalReview articleAcademicpeer-review

10 Citations (Scopus)

Abstract

AIMS: To perform an updated systematic review of randomised controlled trials examining the efficacy of at-home foot temperature monitoring in reducing the risk of a diabetes-related foot ulcer (DFU).

METHODS: Systematic review performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Risk-of-bias was assessed using version 2 of the Cochrane risk-of-bias tool. Meta-analyses were performed using random effect models. Leave-one-out sensitivity analyses and a sub-analysis excluding trials considered at high risk-of-bias assessed the consistency of the findings. The certainty of the evidence was assessed with GRADE.

RESULTS: Five randomised controlled trials involving 772 participants meeting the International Working Group on the Diabetic Foot (IWGDF) risk category 2 or 3 were included. All trials reported instructing participants to measure skin temperature at-home at six or more sites on each foot using a hand-held infra-red thermometer at least daily and reduce ambulatory activity in response to hotspots (temperature differences >2.2°C on two consecutive days between similar locations in both feet). One, one, and three trials were considered at low, moderate and high risk-of-bias, respectively. Participants allocated to at-home foot temperature monitoring had a reduced risk of developing a DFU (relative risk 0.51, 95% CI 0.31-0.84) compared to controls. Sensitivity and sub-analyses suggested that the significance of this finding was consistent. The GRADE assessment suggested a low degree of certainty in the finding.

CONCLUSIONS: At-home daily foot temperature monitoring and reduction of ambulatory activity in response to hotspots reduce the risk of a DFU in moderate or high risk people with a low level of certainty.

Original languageEnglish
Article numbere3549
Pages (from-to)e3549
JournalDiabetes/metabolism research and reviews
Volume38
Issue number6
Early online date23 May 2022
DOIs
Publication statusPublished - Sept 2022

Keywords

  • diabetic foot ulcers
  • secondary prevention
  • temperature monitoring

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